aetiology

Last reviewed 01/2018

Classification:

  • ischaemic - mainly affecting the distal convoluted tubules and loop of Henle; due to "shock", commonly, hypovolaemic, cardiogenic, or septic. Pigment-induced ATN is a special form associated with massive haemoglobinuria - following massive haemolysis - or myoglobinuria - following rhabdomyolysis

  • nephrotoxic - mainly affecting the proximal convoluted tubules. Many agents are implicated, including:
    • antibiotics e.g. gentamicin, cephalosporin
    • anaesthetics e.g methoxyflurane
    • heavy metals e.g. mercury, lead, arsenic
    • chemotherapeutic agents e.g. cyclosporin
    • organic solvents e.g. methyl alcohol, carbon tetrachloride
    • poison e.g. pesticides, mushrooms